1. Adrenal adenoma. Treatment after adrenalectomy.

a. Cortisol
2. Cushing syndrome clinical vignette. Medical management
a. Ketoconazole
b. Spironolactone
3. Alcohol withdrawal-
a. Lorazepam
b. Haloperidol
4. Increase activity of protein kinase and phospholipase: What is increased inside the cells:
a. Ca
b. Na
c. K
5. C6 lesion: What happens to CO, Peipheral resistance and venous volume. Up down arrow.
6. Volume overload(0.9% NaCl infusion):Up down arrow
a. Urine sodium secretion, sodium reabsorption, GFR
7. Pericardiocentesis: Nerve damaged:
a. Phrenic nerve
8. Section of Midbrain to identify medial leminiscus
9. Type 2 DM with obesity: Increased, decreased, absent : Insulin level and antibody against islet
cells.
10. Cholesterol level measurement in a first year student. Follow up level after 2-3 years. Test done
a. Paired t test
b. unpaired t test
c. Chi square test
d. ANOVA
11. 95%confidence interval signifies
a. Level of association
b. Level of clinical significance
c. Power of study
12. Right sensory hemi neglect. Site of lesion
a. Right parietal
b. Left parietal
c. Right temporal
d. Left temporal
13. 6 year old girl has a single pedunculated red beefy mass protruding out of anus. Colonscopy
reveals no other lesions. What type of mass may be seen
a. Hamartomatous
14. A farmer lives with his wife. His daughter found them both unconscious and unresponstive and
had mydriasis
a. Botulism
 b. Parathion
15. Grapefruit juice and Imipramin.
a. CYP 450 3A4
b. CYP 450 2D6
16. ???BRCA 1 pedigree experimental question.
17. ???Experimental vignette related to sickle cells and plasmodium. One of the option was founder
effect.
18. ???Experimental vignette related to HIV.
a. Hemagglutinin binding to surface or something like that
19. Painting liquid swallowed by child develops abdominal pain and vomiting. Dimercaprol used in
treatment.
a. Mercury
b. Lead
20. Pain and edema after laceration
a. Bradykinin
b. PGE2
21. Common in MHC I and II
a. Peptide binding cleft
b. Specific antigen binding
22. Vignette with multiple symptoms along with myoclonus.
a. Serotonin syndrome
23. Opioid withdrawal clinical vignette
24. Atherosclerosis- Process starts with
a. Prechildhood stage- Fatty streak in intima
b. Preadolescent stage- Fatty streak in media
c. Preadolescent stage- Cholesterol streak in intima
25. Cramping abdominal pain followed by hematochazia in a patient suffering from heart failure
with fluid overload.
a. Colonic ischemia
b. Angiodysplasia
26. Case of cryoglobulinemia. Decreased
a. C4
27. Child played with bat but no bite mark
a. Administer both Ig and vaccine
28. Endocardial cushion defect
a. Membranous VSD
29. Coloniscopy preparation
a. Propylene glycol
30. Narcolepsy
a. Decreased orexin
31. Narcolepsy
a. REM sleep within 10 minutes
32. Girl raped. Painful intercourse
a. Vaginismus
33. Pt wants to kill his wife and says has guns
a. Inform police and wife
34. Opioid withdrawal symptoms
a. Clonidine
35. Vignette of gout along with pic showing neutrophils and crystal(single crystal)
a. Gout
36. Acne. Organism
a. P acne
37. Aspergillosis :Histo picture
38. Developmental dysplasia of hip typical clinical vignette
39. Muslim female pt does not want to be examined by only available male doctors
a. Ask the pt if she allows examination with husband present all the time
40. Tongue tip. Lymphatic drainage
a. Submental
th
41. 4 degree perineal tear. Nerve injured
a. Inferior rectal nerve
42. Case of thalassemia. Left shift of oxygen hb dissociation curve. Due to?
a. Persistant fetal hb
43. Viral hepatitis with travel to mexico. Biopsy of liver shows
a. Apotosis of hepatocytes
44. Diabetic pt develops planter ulcer. Feeble but palpable dorsalis pedis and posterior tibial pulse.
Due to:
a. Sensorimotor neuropathy
b. Vascular
45. Diff bet lisinopril and valsartan.
a. Increased AT I in lisinopril
46. Temp charting showing increased temp from 15 days to 50 days. Diagnosis
a. Pregnancy
47. VEAL CHOPP: Late deceleration
a. Hypoxia
b. Malpresentation
48. Lung small cell carcinoma
a. Decreased sodium
49. Lung cancer Not associated with smoking
a. Bronchoalveolar carcinoma
b. Mesothelioma
c. Small cell
d. Squamous cell
50. Gastric motility. Primary stimulus
a. Ach
51. Graph with dose in x-axis and no of people dying in y axis . Least toxic drug at 20mg/dl
a. D
52. Alendronate- Inhibits osteoclast
53. 46 years old male with lower GI bleed. Next step
a. Colonscopy
54. Forest plot easy question
55. ADHD: Pathophysiology
a. NE transporter
56. Perimenopausal syndrome- Irritable patient 45 years old: Had to diagnose.
57. Acetyl coA carboxylase inhibitor which pathway inhibited
a. Fatty acid synthesis
58. Case of hyperammonemia. Test done to support diagnosis
a. Quantitative amino acid estimation
59. Clinical vignette of anorexia. Had to diagnose.
60. Pt on ventilator but with full mental capacity wants to withdraw ventilator but pt family
members wants to continue ventilator. Pt removes ventilator
a. Both ethical and legal
61. 20 out of 100 people has diabetes. What is the probablility of 2 ramdom people suffering from
DM:
a. 0.2 x 0.2= 0.04
62. Parkinson disease vignette. Biopsy shows
a. Eosinophilic inclusion
63. Murmur: MR
64. Murmur: AR.
a. Marfan
65. Quadruple screening: A and E decreased, B and I increased
a. Downs
66. MCV 123 pancytopenia with bone pain
a. MDS
b. Nutritional deficiency
67. Farmer with pancytopenia
a. MDS
68. Main cell responsible for killing tumor cells
a. CD8+T cells
b. NK cells
69. Pt on dialysis catheter develops fever. Emperic therapy
a. Vancomycin
70. Another question on vancomycin
71. Features suggestive of subacute combined degeneration in a patient of cystic fibrosis. Diagnosis
a. Vit E deficiency
72. Thiamine deficiency history. Affected dehydrogenase
a. Pyruvate dehydragenase
73. Carboxylation deficiency. Supplement to improve
a. Biotin
74. Picture of staghorn calculi. Predisposed by infection with
a. Proteus mirabilis
75. Warfarin
a. Carboxylation
76. Chinese man develops flushing and uneasiness after alcohol
a. Defect in aldehyde dehydrogenase
77. Water retension in connective tissue due to binding of water to
a. Proteoglycan
78. Picture of staghorn calculi: Gross picture fresh sample. Diagnosis
a. Hydronephrosis
79. SLE patient under treatment. Developed bilateral crackles. Initial investigations?
a. Chest x ray
80. Methotrexate tt. Monitoring of
a. LFT
b. PFT
81. Pt taking oxacillin. Microscopic picture of kidney showing tubules surrounded by inflammatory
cells(Eosinophils). Cytokines involves
a. TNF alpha
82. Essential throbocythemia. Increased(unregulated) activation of
a. Thrombopoeitin
83. Skin cut by knife. First response
a. Vasoconstriction
84. Long standing diabetes patient develops loss of vision. Fudoscopic pic given showing increased
vascular markings. A drug with action against which
a. VEGF
85. Post cataract surgery gram positive elongated rods: Organism?
a. Bacillus
86. Pic of pityriasis. Initial investigations?
a. KOH mount
b. Skin biopsy
87. A trial was done on a small number of icu patients to determine the effectiveness of a new
treatment. The treatment is very cumbersome but the results show that it provides better cure
rates. What can we infer fromm the result?
a. The results are significant for this trial but further studies on larger number of SICU
patients now need to be carried out
88. BP measurement is done in a fair. 4 readings per person is taken and the data analysesd. If they
had taken 10 readings per person what would have happened ot the SD of the data?
a. Can’t be determined
b. Increased by 5%
c. Increased by 10%
 d. Decreased by 5%
e. Decreased by 10%
89. Population pyramid of a developing nation and developed country given. Asked to compare the
birth rates and the death rates.
90. A child has hairfall with an area of clearing on the scalp. The area has numerous black dots. His
friend has a similar picture. A scraping is taken. What may be seen on microscopy?
a. Septate hyphae
91. Vignette describing achalasia
a. Destruction of enteric neurons
92. EBV infections. Predisposes to
a. Lymphoma
93. Atypical lymphocytes seen post kidney transplant. Heterophile test not mentioned.
a. CMV
94. Peripheral smear of atypical lymphocytes given in a case of EBV infection. What are these cells
a. Reactive T lymphocytes
b. Reactive B lymphocytes
c. Infected T lymphocytes
d. Infected B lymphocytes
95. Pic of a worm in petridish shown. Species
a. Diphyllobotrium latum
96. Pt went of Madagascar. Brackish and fresh water contact. Generalised lyymphadenopathy fever
and rash. Diagnosis
a. Schistosoma
97. Vignette of scabies showing pic of back with lesion. And similar history in childrens. Rahes are
itchy. Treatment
a. Permethrin
98. CV of roseola. Virus causing this lesion is similar to
a. VZV
99. Typical vignette of roseola. Diagnosis asked.
100. 2 month old boy has bladder distention. Cause?
a. Posterior urethral valve
101. Vignette of renal stone. X ray shows no stone. Diangosis
a. Uric acid stone
102. Marfanoid habits. Had a brother who died of stroke at young age. Asked what may be
found in this patient
a. Increased methionine level
103. Long vigneete and asked increased expression of IL 10 gene
a. Acetylation of histone
104. Valve transplant pt. PBS
a. Schistocytes
105. What decreased in hemolytic anemia
a. Serum haptoglobin
106. ECG – ST elevation MI(II III aVF)
107. ECG – 2nd degree heart block( Was Mobitz type 2 but type was not asked)
108. ECG- LBBB ecg given. Asked where is the problem:
a. Left bundle
109. Testis histology to identify
110. ATN. What is seen
a. Necrosis
111. Vignette of Hashimotos. What is seen
a. Lymphocytes with germinal centre
112. A pregnant patient with features of hyperthyroidism with exophthamos. TSH low T3 T4
high.
a. Graves disease( Due to exophthalmos and ?? presence of Anti TSH antibody I chose this)
b. Pregnancy changes
113. Folate deficiency
a. Increased dUMP to dTMP
114. Transcription factor jun is normally phosphorylated but cannot translocate to nucleus.
Problem with?
a. Importin
115. MRI of knee with arrow showing meniscus. Function of pointed structure.
a. Shock absorber
116. Vignette described holoprosencephaly. Which gene is defective
a. Sonic hedgehog gene
117. ATRA given during pregnancy. Causes treatogenic effect. Due to problem with
a. HOX gene
118. What percentage of PE will develop infarction?
a. 10%
119. Folate deficiency.
a. Decreased nucleotide synthesis
120. Women has history of DVT and repeated miscarriage
a. Antiphospholipid syndrome
b. Aneuploidy
121. Patients with breast cancer develops ataxia. Antibody against
a. Purkinje cells
122. Patient has an accident. Right leg amputated. Pain in left leg. Diagnosis?
a. Causalgia
123. Xray showing tibial and fibular fracture.
a. Anterior compartment
124. Similar type of vignette with question asking about the nerve involved?
a. Deep peroneal
125. Km increased and Vmax normal. Graph was given.
a. Decreased affinity
126. Glucose levels and HbA1c levels were measured in a fair. Mean glusoe 124, SD- 12.4.
HbA1c mean 6.5 SD was 6.5, SD – 0.065
a. Variance of gluose measurement is greater than variance of Hba1c
127. Vignette of galactosemia including cataract. What should be avoided
a. Lactose
128. Muscle pain on exertion and no increase in lactate in blood after exercise. Defect int?
a. Glycogenolysis
129. Increased LDL. What is defective
a. LDL receptor
130. Patient with pneumonia does not improve with antibiotics. Examination show dullness
on percussion. What is the diagnosis?
a. Empyema
131. SLE patient under treatment. Which vaccine should not be given?
a. Varicella
132. Vignette of herpes.What pathology may be present
a. HIV
133. Typical vignette of 21 hydroxylase deficiency asking for diagnosis
134. 2 ureters: Due to duplication of
a. Ureteric bud
135. MCP joint replacement done. Flexor deformity of MCP and ulnar deviation of hand.
Elongation of which tendon
a. Flexor carpi ulnaris
136. Malnourished child. Most affected to least affected
a. Wt > ht> head circumference
137. 106C man lost for many days/ Heat loss by
a. Evaporation
138. Man lost in desert for 7 days. Least likely process
a. Glycogenolysis
139. Nurse who likes to bike has erythematous cracking of the dorsum of the hand only and
taking ibuprofen for backpain. Advice
a. Discontinue ibuprofen
b. Use sun protective lotion
c. Use mild soap
140. Ebola. Mode of transmission
a. Direct contact
141. Saturday night palsy in a soldier. Nerve damaged?
a. Radial nerve
142. Doctor treating a patient develops feelings towards her. What should the doctor do?
a. Maintain professional boundary and keep treating the patient and don’t tell her
anything
b. Terminate the doctor patient relationship but don’t tell why
c. Terminate the doctor patient relationship but tell her why
143. Mechanism of action of V, chorerae toxin
a. Opens Cl channel
144. Fever with diarrhea and maculoapular rash. Organism tramsitted
a. Home shelter
145. PCOS
a. Increased insulin
146. Rash. Pautriers microabscess and Cells stained with CD 3
a. Sezary
147. Osler weber Rendu syndrome. Pic of lip. What mat be seen
a. GI vascular malformation
148. Mass in rectum. Drainge to
a. Inferior mesenteric node
149. Maxillary sinusitis. Sinus opens into
a. Middle meatus
150. Clinical vignette of mastoiditis. CT scan given diagnosis asked
a. Mastoiditis
151. Experimental questions showing a graph. One was a graph of normal cells. One was a
graph of cells with increased production of a compound. It was evident from the graph that they
were surving more than the normal cells. Why>
a. Telomerase
152. Tetrodotoxin- graph given
a. Sodium channel defect
153. Child with strabismus if not treated
a. Amblyopia
154. Pt with gout started on antitumor develop acute gouty arthritis dur to
a. furosemide
155. Aneurysm- clot composed of
a. Fibrin
156. Myxoma-histo. Common location
a. Left atrium
157. Countertransfereance vignette- easy one
158. Orthopaedics surgeon collects data regarding morbidity preop and post op
a. Case series
159. 50 years old native marican comes for HME everything normal. Your response
a. Everything is fine lets meet after 1 year
160. Primary prevention
a. Vaccination
161. Emphysema – Pressure volume cuurve
a. Curve
162. X ray abdomen.
a. Anal atresia
163. Xray abdomen. Multiple air fluid level. Cholecystectomy done few months back with
CBD exploration.Problem in
a. Ileum
164. Cleft lip
a. Malformation
165. Insulinoma CV
166. Pregnant pt heartb burn
a. GERD
167. Enteropeptidase deficiency
168. Sjogren syndrome- Chance of
a. Lymphoma
169. Pagets disease
a. Ductal carcinoma
170. ICU patient features suggestive of cholecystitis. Next investigations
a. USG liver/GB
171. FRC from graph
172. Swan neck deformity
a. Anti CCP
173. Experimentalhind limb of mice car then the bud grown on culture no muscle cells.
Defect
a. Defect in migration of myotomal cells
174. Stress incontinence with coughing
175. Stress incontinence with cystocele
176. Urge incontinence- Nerve affected
a. Pelvic splancnic nerve
177. TEF repair- Nerve affected
a. Recurrent laryngeal nerve
178. Arterial supply of the ileum- Superior mesenteric artery
179. Ovarian tumor- Metastasis to para-aortic lymph nodes
180. Testicular torsion: Artery involved
a. Testicular artery
181. Entameba histolytica- Picture
182. Hepatic flexure- arterial supply
a. Right colic and middle colic artery
183. Portosystemic shunt
184. Left gastric vein- oesophageal vein- azygous and hemiazygous vein
185. Left hepatic vein and midlle hepatic vein if obstructed will result in reduced flow to
a. IVC
186. Painless bleeding. Bladder wall irregularity. What investigation
a. Urine cytology
187. Peterm baby died. Autopsy findings
a. Cuboidal cells with reduced lamellated inclusions
188. Neonatal respiratory distress syndrome
189. Renal artery stenosis. Increase in
a. Renin
190. Lactic acidosis
191. Diabetic ketoacidosis
192. PI02= 150, PaCo2= 40, PaO2=74, RI=1
a. A-a gradient= 36
193. 16 years old female came for HME with mother. Doctor asks mother to stay outside.
What should be the response of the doctor after this
a. Do you have sex with male female or both
194. Histology of nasal polyp
195. Rb
a. G1-S
196. VAncomycin resistance enterococci
a. Daptomycin
197. Drug that inhibits transcription
a. Rifampicin
198. Anticipation – Classic vignette
199. Mitochondrial inheritance- pedigree
a. Defect in mitochondrial electron transport chain enzyme
200. Intestine is transplanted in place of oesophagus. And after few years biopsy is done.
Histo pic of squamous lining is given. Due to
a. Metaplasia
201. Hereditary spherocytosis
a. Cytoskeletal defect
202. Left atrial enlargement only. Problem in which valve
a. Mitral
203. Patient on antidepressant with features of primary polydypsia
a. Primary polydypsia
204. Clinical vignette in a 40 years old male with back pain(POtt spine) and respiratory
features, fever and haziness in the upper lobe of the lung.
a. Tuberculosis
b. Lung carcinoma with metastasis to vertebra
205. Features of osteomyelitis back. Next step
a. MRI
206. Thyroidectomy- Features of hypocalcemia. UP down arrow question
a. Serum calcium/ serum phosphrous
207. Contractility and preload Graph few minutes after MI
208. IgA nephropathy.
a. IgA deposits in Mesangium
209. VDJ recombination calculation. Individual V D J given.
210. Eosinophilic granulomatis with polyangitis histology.(Either this or wegners. Only one
option was there). Histo section was given showing granulomatous vasculitis.
211. Major depressive disorder. Clinical vignette. Had to diagnose.
212. Randomised controlled trial.
213. Gross pic of mass in the base of frontal lobe with features of frontal lobe lesion. Clinical
features was present for 6-7 years
a. Meningioma
b. Glioblastoma
c. Pituitary adenoma
214. Acute rejection clinical vignette. Transplant 2 months back. Histo pic was given of kidney
with plenty of lymphocytes.
215. Flacid and tense bulla present. Antibody against laminin 1. Skin section given. Had to
show basement membrane.
216. Anterior spinal artery obstruction vignette
217. Heparin induced thrombocytopenia. What to give
a. Argatroban
218. Multiple myeloma vignette. What is the pathogenesis.
a. Gene amplification
219. Cyclophosphamide. Mechanism of action
a. Cross links DNA
220. Halitosis
a. Zenkers diverticulum
221. Constipation for 3-4 months
a. Eat fiber containing foods
222. Glargine- 24 hr insulin
223. Staphylococcus toxic shock syndrome clinical vignette due to
a. Lymphoctyes
b. Neutrophils
c. Monocytes
224. Central DI
225. Insulin-
a. Receptor tyrosine kinase
226. Gall bladder cholesterol stone
a. Fibrates
227. Pt died before pt’s family came. Pts family wanted to know whether pt died peacefully.
a. Beneficience
228. Confounding bias
229. Prevalance increase- PPV increased
230. Phase 1 study
231. Phenylephrine
232. Pleural effusion – exudative from light criteria
233. Diabetes- Mononeuropathy
234. Spiral fracture in a child
a. Non accidental
235. Hydrocele- Procesus vaginalis
236. Uterine atony-
a. Oxytocin
237. Methylphenidate- MOA
238. Klinefelter syndrome
a. Small testis
239. Pregnant women has increased prolactin but lactation does not occur before delivery
due to
a. Progesterone(Estrogen was not there in the options)
240. Transtuzumab - MOA